Nurse Reviewer (LPN/RN) Disability Claims
Location:Fully Remote (U.S. Only)
Pay Rate:$27.50/hour (W2)
Contract Duration:September through February (with potential extension)
About the Role
Are you a licensed nurse with a passion for clinical assessment and disability case management? Join our clientsDisability team as aNurse Reviewer, where youll leverage your clinical expertise to evaluate disability claims, support return-to-work strategies, and collaborate with claim specialists, healthcare providers, employers, and claimants.
In this role, youll play a critical part in ensuring fair, evidence-based disability determinations while helping individuals navigate their recovery and return to productive employment.
Responsibilities
- Conduct comprehensive clinical reviews forShort-Term Disability (STD), Long-Term Disability (LTD), and Family & Medical Leave (FML)claims.
- Evaluate medical records, treatment plans, and physician documentation to determine functional abilities and disability status.
- Compare clinical findings against disability guidelines to identify functional limitations and residual work capacity.
- Develop and recommend individualized, goal-focused Return-to-Work (RTW) plans.
- Communicate with claimants, physicians, employers, and internal partners to obtain clinical clarification and facilitate timely claim decisions.
- Identify medical, social, psychological, vocational, and workplace barriers impacting return-to-work outcomes.
- Provide clinical consultation and education to Disability Claim Specialists regarding medical conditions, treatment plans, and disability assessments.
- Collaborate with cross-functional teams to ensure consistent application of disability policies and best practices.
- Support continuous improvement initiatives and participate in special projects as assigned.
- Maintain compliance with company policies, confidentiality standards, regulatory requirements, and ethical guidelines.
- Serve as a clinical resource while embodying Clients values and commitment to customer care.
Minimum Qualifications
- CurrentLPN or RN licensethat is active and in good standing throughout the duration of the assignment.
- Minimum3 years of clinical nursing experienceworking with adult patient populations.
- Associate degree in Nursing required.
- Strong understanding of medical terminology, clinical documentation, and patient care practices.
- Excellent analytical, critical thinking, and clinical decision-making skills.
- Strong verbal and written communication skills.
- Ability to manage multiple priorities while meeting deadlines.
- Comfortable working independently in a fully remote environment while collaborating across teams.
- Proficiency using multiple systems, applications, and technology platforms.
Preferred Qualifications
- Bachelors degree in Nursing (BSN).
- Experience in one or more of the following:
- Disability insurance
- Workers Compensation
- Case Management
- Occupational Health
- Rehabilitation Medicine
- Private Rehabilitation
- Risk Management
- Home Health
- Knowledge of disability duration guidelines.
- Experience interpreting medical documentation for disability determination.
- Familiarity withCPT and ICD coding.
- Experience developing Return-to-Work programs and managing disability cases.
What Makes You Successful
Were looking for professionals who are:
- Detail-oriented with exceptional clinical judgment.
- Skilled at interpreting complex medical information.
- Comfortable communicating with physicians, employers, and claimants.
- Organized and able to manage competing priorities.
- Collaborative, empathetic, and customer-focused.
- Confident making evidence-based recommendations.
- Passionate about helping individuals safely return to work.
*Upon acceptance of the offer, you will be required to submit to a background check, including employment and education verifications and urinalysis drug screening**
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